Focus on UCSF Fresno Newsletter August 2019

Teach

First Cohort of Students in the UCSF SJV PRIME Start Classes This Month

2019 SJV PRIME Students

L to R (front) Lemuel Vince Rivera, Amitoj Singh, Reyoot “Rey” Berry ; (back) Stephen Georgiou, Marcus Cummins and Alejandro “Alex” Alejandrez

By Brandy Ramos Nikaido

This month’s start of the new UCSF San Joaquin Valley Program in Medical Education (SJV PRIME) comes at a critical time, as California is facing a projected shortfall of up to 4,100 primary care clinicians in just 10 years, according to the California Future Health Workforce Commission. The San Joaquin Valley – the region that stretches from Stockton to Bakersfield – already has a severe shortage of physicians and is one of the fastest growing areas in the state. In addition, with about one-third of the region’s physicians at or near retirement age, the Valley will be hit especially hard by the shortage of doctors.  

Six medical students – all from the Valley – were admitted to UCSF SJV PRIME, a program specifically for future physicians who are committed to providing high-quality, culturally competent and accessible medical care that addresses the Valley’s unique health needs.

“The aim of SJV PRIME is to take students from the Valley, train them here, offer them residency training in the Valley with the hope they will stay to practice,” said Loren Alving, MD, a neurologist and director of the SJV PRIME.

The program started in 2011 as a collaboration among UC Merced, UCSF Fresno, the UCSF School of Medicine, and the UC Davis School of Medicine, with UC Davis serving as the medical degree-granting institution.

In July 2018, UCSF Fresno was approved as a branch campus of the consistently top-ranked UCSF School of Medicine by the Liaison Committee on Medical Education, the accrediting body for medical degree granting institutions in the U.S.  The designation made UCSF the degree-granting institution for SJV PRIME and paved the way for students to spend the bulk of their training at UCSF Fresno and other Valley locations.

With the branch campus approval came a flurry of activity to prepare for students admitted to the new SJV PRIME. A taskforce, co-chaired by Dr. Alving and Ann Poncelet, MD, also a neurologist and director of UCSF Academy of Medical Educators, was assembled.

“In just over a year, we had to develop various aspects of the four-year program to integrate with the BRIDGES curriculum (the name of the UCSF medical school curriculum),” said Dr. Alving.

BRIDGES is a completely updated curriculum that was launched by UCSF in 2016 to prepare physician-leaders to transform 21st century health care.  As UCSF medical students, SJV PRIME students spend the first 18 months at the main campus focusing on foundational and health system sciences and principles of discovery. They also learn about health issues impacting the Valley and remain connected to the region with intermittent periods of time spent learning and conducting research locally such as with UC Merced faculty. After the initial 18 months, SJV PRIME students spend the remainder of their training – about two and a half years – at UCSF Fresno. Rotations take place at clinical sites like Community Regional Medical Center, Family HealthCare Network’s Ambulatory Care Center in Fresno, VA Central California Health Care System, University Centers of Excellence and other family medicine clinics in the Valley. 

Alving credited Catherine Lucey, MD, vice dean for education at UCSF, Michael W. Peterson, MD, associate dean at UCSF Fresno, taskforce co-chair Dr. Poncelet, and everyone on the taskforce with being instrumental to the successful development of the program and consistent with the high-quality of  the UCSF School of Medicine.

Students in the first UCSF SJV PRIME cohort include:

Alejandro “Alex” Alejandrez was born in Mexico, immigrated to the U.S. when he was two, and grew up in Madera, CA. He graduated from UC Santa Cruz and is a U.S. Army reservist. Alejandrez is taking time off to go to medical school and will then serve as a medical officer prior to coming back to the Valley. His interests include taking care of veterans and underserved populations.

Reyoot “Rey” Berry was born in Ceres, CA, grew up in Modesto and graduated from Fresno State. She looks forward to gaining the tools and experiences to serve communities in the Valley that face health care barriers such as LGBTQ, mental health, homeless, and immigrants.

Marcus Cummins was born and raised in Fresno. He attended Buchanan High School and graduated from UC Davis. Marcus is excited about the opportunity to train at one of the nation’s top medical schools in his hometown and in the Valley where there is a great need for physicians.

Stephen Georgiou grew up in Los Banos and graduated from UC Berkeley. He was introduced to the field of medicine by his father who is an ob/gyn in Los Banos. Both his dad and mom instilled in him the importance of giving back to the community and helping the underserved. Originally from Mexico, his mother was a pediatrician but retired when he was born. He says SJV PRIME is a perfect fit for his long-term goals and he looks forward to caring for patients early in his medical education.

Lemuel Vince Rivera was born in the Philippines and moved to the United States in 2005.  He relocated to Fresno in 2009 and graduated from Fresno State. While at Fresno State, Lemuel worked at Community Regional Medical Center as a scribe in the emergency department. He looks forward to learning more about the health inequities that exist in the region and coming back to the Valley to work with underserved populations.

Amitoj Singh, from Fresno, is a UCSF Fresno Sunnyside High School Doctors Academy and UCLA graduate. As a Doctors Academy student, he learned about many of the health disparities that exist in the Valley. His interest in pursuing medicine was reaffirmed at UCLA. Through SJV PRIME and early in his medical education, he looks forward to helping the community he one day hopes to serve as a physician. 

SJV PRIME students and peers participated recently in the time-honored “white coat ceremony” at UCSF School of Medicine. UCSF SJV PRIME Associate Director Leticia Rolon, MD, was the keynote speaker.

Next steps for development of the SJV PRIME curriculum include finalizing the extended clinical rotations for students and developing a summer research program in conjunction with UC Merced.

When asked how the community can support SJV PRIME, Dr. Alving said, “We need enthusiasm to keep students here, community partners to engage with the students, and financial support – scholarships – to help students. Many of the students come from underserved backgrounds. Many are first-generation college students. Medical school is stressful enough without having to worry about being hundreds of thousands of dollars in debt.”

Dr. Andrea Long

Care

UCSF Fresno Surgeon Leads Changes in LGBTQ-
Friendly
Medical
Charting

By Barbara Anderson

UCSF Fresno trauma surgeon Andrea Long, MD, is working to improve health care for Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) patients one electronic medical chart at a time.

With full support and encouragement from her boss UCSF Fresno Chief of Surgery, Jim Davis, MD, Dr. Long is the medical leader of a Community Medical Centers LGBTQ Steering Committee tasked with educating medical providers and support staff about LGBTQ-friendly upgrades to the electronic medical records system.

 “We started this project out of the recognition that there was a need, not only to improve our documentation, but to improve the overall understanding and care of our LGBTQ patients,” Dr. Long said.

Long said all members of the committee, from representatives from human resources, informatics, administration, clinical nurse managers/supervisors, educators and more contributed to the effort and deserve credit for the success of the project.

Rochelle Tarascou, MSN, MBA, RN, who is manager of clinical learning at Community Regional Medical Center, was the project leader for the multi-disciplinary LGBTQ Steering Committee. “Our primary concern was to make sure patients get the best care possible,” she said.

In research for the training, Tarascou said the team learned that LGBTQ people nationwide have reported experiencing discrimination, denial of care and fear of harassment in health care settings.

According to one survey, 70% of transgender or gender-nonconforming respondents, 63% of respondents with HIV and almost 56% of lesbian, gay or bisexual respondents had experienced at least one of the following types of discrimination in a health care setting: being refused needed care, health care professionals refusing to touch them or using excessive precautions, health care professionals using harsh or abusive language, being blamed for their health care status or health care professionals being physically rough or abusive.

The Community LGBTQ-friendly training includes how and where sexual orientation and gender identity data is recorded on the electronic medical record. It also includes how to record chosen name and correct pronouns in the patient chart, and how to have respectful conversations while asking about sexual orientation and gender identity. The training provides information on terms, such as non-binary (people whose identity isn’t exclusively male or female); pangender (people who feel they identify with all genders); transgender (umbrella term for people whose gender identity differs from what is typically associated with the sex assigned at birth) and cisgender (a person whose gender identity aligns with the sex assigned at birth).

The electronic medical record also allows for documentation of organs still present when appropriate for patient care. This is important information for both current medical treatment and preventative screening.  A transgender woman may still have her prostate after gender confirmation surgery, and she might still need a prostate screening, for example, Dr. Long said.

“You can’t really establish a relationship with a patient – and a patient is going to have a hard time feeling safe in our care –  if you don’t know how to ask the right questions,” Dr. Long said. “And using a person’s name that they provide, using their gender identity rather than focusing on their sex assigned at birth, addressing them by the right pronoun – all of those go a lot into establishing a relationship with a patient.”

UCSF faculty in Fresno are welcoming the training, Dr. Long said. “They are asking for this education because they know their students, their residents, are coming unprepared from medical schools and they feel this is important for all of us to know as providers.”

Julie Nicole, MD, an obstetrician/gynecologist, who provides transgender care in the Fresno area and a volunteer faculty member at UCSF Fresno, said the changes to the electronic medical record have made her work easier. In the past, she had to manually correct the record to include a patient’s name or pronoun, but now these are automatically accepted. “This is very helpful,” she said. “We can respect the patient and respect their identity.”

Dr. Long expects questions regarding sexual orientation and gender identity will soon become a routine part of any physician/patient discussion. “If you ask all the patients, at all times, it becomes much easier to have the conversation,” she said. “Patients expect it. And patients who have no idea what ‘sex assigned at birth’ or what ‘gender identity’ means, will get used to hearing those questions as well,” she said.

She encourages anyone uncomfortable with the new LGBTQ-friendly medical record to seek help. “Make yourself comfortable with it, because our patients aren’t going away,” she said. “Our patients deserve respect and we need to give them the best care that we possibly can.”

Together, UCSF Fresno and Community Medical Centers are improving health through patient care and medical education

 

Research

UCSF Fresno Pulmonologist and Colleagues Look at Impact of Meth Use

Vijay Balasubramanian, MD, MRCP (UK)

By Barbara Anderson

Methamphetamine, a cheap and highly addictive stimulant, is one of the most widely abused drugs in California, and four studies led by UCSF Fresno pulmonologist, Vijay Balasubramanian, MD, MRCP (UK), are the first to look at effects on hospital utilization, critical illness, pulmonary hypertension and clinical outcomes in the Central Valley.

UCSF Fresno physicians see hospital patients daily who have used methamphetamine, but the incidence and prevalence of the abuse has not been well studied. “I wanted a better understanding because we have such a robust population here and it is so important to understand the epidemiology of methamphetamine use and its burden on the health care industry,” Dr. Balasubramanian said.

To evaluate the scope of the drug use, he led Stimulant Associated Disease Database (SADD), a retrospective observational registry study at Community Regional Medical Center (CRMC) in Fresno. The study involved patients who came to the emergency department between January and December 2013 and had a urine drug screen that was positive for amphetamine. (Due to the prevalence of methamphetamine use, all positive screens were considered “methamphetamine positive” for study purposes. False positives can occur with other chemically similar stimulant agents such as pseudoephedrine or methylphenidate.)

UCSF Fresno physicians, with Dr. Balasubramanian as principal investigator, used SADD for three studies: “Critical Illness Associated with Methamphetamine Exposure in the Central Valley of California (CRIME)” in 2016; “Pulmonary Hypertension: Prevalence and Incidence Amongst Methamphetamine Users (PH-Prime Study)” in 2017; and “Methamphetamine Abuse & Its Health Care Impact in the Central Valley of California” in 2019. The research has appeared in “CHEST Journal” and “Science Forecast Journal of Emergency Medicine Forecast”

The studies highlight the widespread use of methamphetamine in the Valley, said UCSF Fresno hospitalist Manjit Singh, MD, lead researcher on “Methamphetamine Abuse & Its Health Care Impact in the Central Valley of California.”

Singh’s research team studied 4,578 urine drug screens, of which 1,207 or 26% were positive for methamphetamine. Of the patients with positive urine screens, they pulled medical records for 1,011 patients.

Patient records showed more than half of the methamphetamine abusers came by ambulance to the emergency department — and the most frequent clinical presentations were suicidal/homicidal ideations (22.4%), followed by altered mental status/agitation (15.5%); trauma (12%) and chest pain (11%). Overall, 66% had heart-related health issues related to methamphetamine abuse and 26% had pulmonary health conditions.

The patients had seven times as many inpatient admissions compared to the general hospital population. And based on the average length of stay, each hospitalization had an average cost of approximately $9,090 per year, which translated into an additional yearly cost of $9 million for 1,000 methamphetamine users.

“Methamphetamine users come in to the hospital and we treat them and send them out, but these studies show how much they are using the health care system and the burden it is putting on the health care system,” Dr. Singh said.

For the CRIME study, researchers analyzed medical charts of 688 patients with positive urine screens who were admitted to ICUs. The average ICU patient was male, and the average age was 45 years. Admitting diagnoses included altered mental status (16.07%), septic shock, (12.5%), gunshot wound (10.7%), blunt trauma (7.14%), seizure (7.14%), cerebrovascular hemorrhage (7.14%), stab wounds (5.3%), motor vehicle collision (5.3%). A few others presented with auto versus pedestrian injury, hypertensive emergency, acute kidney injury, train versus pedestrian injury, and respiratory failure.

Two studies shepherded by Dr. Balasubramanian, also medical director of the UCSF Fresno Pulmonary Hypertension Program at CRMC, involved methamphetamine in association with pulmonary hypertension. PH is high blood pressure in the lungs and methamphetamine is considered a “likely” cause of pulmonary arterial hypertension (PAH), a form of PH that is life threatening and potentially fatal.

“I am sitting at a center where 40 percent of my practice is methamphetamine-associated PAH,” Dr. Balasubramanian said. “It’s literally such a rampant issue in our Central Valley, and it had not been studied at all.”

The PH-Prime Study provided an estimate of the prevalence and incidence of PH in patients with methamphetamine use. The study revealed a cumulative incidence of 6/1000 patients and an overall prevalence of 10/1000 patients for PH with positive tests for methamphetamine.

For a separate PAH study, UCSF Fresno researchers found 56 patients. “Methamphetamine Abuse – Characteristics, Outcomes, Logistics in Pulmonary hypertension in a center at Central Valley of California (MEA CULPA-CVC Study)” was the first of its kind,” Dr. Balasubramanian said.

The PAH study compared methamphetamine-associated patients with idiopathic PAH patients who had no known cause for their disease, said Kirat Gill, MD, who led the research during a pulmonary critical care fellowship at UCSF Fresno. The methamphetamine-associated patients were diagnosed at a much younger age and had a higher mortality, she said.

The exact reasons for the higher mortality in the methamphetamine-associated PAH patients are unknown, although poor adherence to therapy is one possibility, Dr. Gill said. “Very little is known about methamphetamine-associated PAH patients because there are not a lot of centers in California, she said. “We’re one of the few – and not all centers have as high a methamphetamine usage in their patient population as compared to Fresno.”

More research definitely is needed about methamphetamine-associated PAH, but that’s the tip of the iceberg, Dr. Balasubramanian said. “One of my aims is to understand methamphetamine abuse, not only from a PAH perspective, but from the whole human disease state.”

 

Gaston and SJV PRIME Students

Partner

SJV PRIME Students Provide Mentoring to Fresno Middle School Students

By Barbara Anderson

It’s difficult to say who learned the most last year at Rutherford B. Gaston Sr. Middle School in southwest Fresno — students in the Men’s Alliance and Latino Studies classes or two medical school students in the UC San Joaquin Valley Program in Medical Education (SJV PRIME).

“It was a win for us and a win for them,” said Tyler Carcamo, a fourth-year SJV PRIME student who, along with fellow medical student David Araiza, participated in a pediatric outreach project at the middle school, visiting every other week to expose the youths to medicine and encourage positive health behavior.

“The third year of medical school can get tough and that was one of our outlets to teach and be mentors and also learn from the Gaston students,” Carcamo said.

Carcamo and Araiza made an impression on the Gaston students. “They were like celebrities,” said Gaston teacher Kevin Tatum Jr. “They’d be asking, ‘where’s David, where’s Tyler? When are they coming?’”

The SJV PRIME students were role models for youths at the largely minority, high-poverty middle school. “It’s good for my students to be around people who are students themselves and who are working on getting advanced degrees,” Tatum said. “It may inspire my students to one day get into the medical field, whether it’s being a doctor, being a registered nurse, whatever it may be. It exposes them to that career path.”

Community outreach is an integral component of SJV PRIME. “One of the big reasons to have the SJV PRIME is to grow physician leaders in the Valley, and the way to do that is to have them engage with the community,” said Loren Alving, MD, director of UCSF SJV PRIME.

SJV PRIME students develop leadership skills and gain an understanding of the lives of students and the social determinants of health that are affecting them, said Renee Kinman, MD, an associate program director of UCSF Fresno Pediatrics, and co-developer of the outreach program with Serena Yang, MD, chief of Pediatrics, and Erica Gastelum, MD, assistant clinical professor at UCSF Fresno. “It’s becoming recognized in medicine that you can’t just work in the exam room – 60% of the things that affect health are not things you can deal with in your exam room – education level, poverty, gang violence – all of these factors really affect your health,” Dr. Kinman said.

Araiza and Carcamo learned about the students’ lives and shared stories of their own backgrounds and career paths to medical school. “They talked about the tough times they had and the great times,” Tatum said.

Araiza is the first in his family to graduate from college. After high school, he got a job and attended San Joaquin Delta Community College, taking five years to earn enough credits to transfer to UC Merced. “But I graduated from UC Merced in two years,” he said.  He worked for three years at UC Merced in an ecological laboratory before applying and being accepted to SJV PRIME.

 Araiza said he wanted Gaston students to understand that “you don’t have to do it just one way, everyone has a different path to get into medicine.”

Carcamo, is the first in his family to go to medical school. He grew up in Belize and lived in the Central American country until age 12, when his family settled in Bakersfield. A love for basketball and music — and keeping a positive outlook on life — were aspects of himself that Carcamo shared with Gaston students in the Latino Studies class and The Men’s Alliance, a leadership class for at-risk teens.

Carcamo and Araiza, in collaboration with Tatum, surveyed the students about health issues. Nearly all of the youths had family members who had chronic medical conditions, in particular diabetes and hypertension. Inspired by Hip Hop Public Health, a collective of educators, entertainers and health professionals who use hip-hop music to empower youths, Carcamo and Araiza provided the Gaston students with information about the diseases and asked them to express what they had learned through lyrics/rhymes that could be turned into a rap song. “We wanted to develop a project that would get their interest, and I think for kids these days they listen to music a lot and it’s a big part of their culture,” Carcamo said.

The students produced a rap song about diabetes and worked on a video with a health prevention message.

“The coolest part is how much the students learned,” Tatum said.

“People don’t give them a chance to be brilliant,” Carcamo said. Araiza agreed: “They were a group of pretty amazing students.”

Gaston students taught the SJV PRIME students a lesson, too. “We have to listen before we implement things rather than going into a situation saying, ‘this is what you need and I’m going to fix it for you,’” Carcamo said.

By listening to the Gaston students, a partnership developed between the youths and the SJV PRIME students. The youths identified health issues that were important to the community and the SJV PRIME students gave them information to help that they could take home to their families. Through the community outreach, the youths became change agents in the community and SJV PRIME students were shown that they can have an effect in the community, Kinman said.

Hopefully, the medical students will return to the Valley for residency and to practice medicine, she said. “And when they come back, they actually will be ready to start improving the health of the community. And they will have some of the connections in which to do it.”

SJV PRIME is a tailored track for medical students to prepare them to address the unique health needs of the Valley’s diverse and underserved populations. SJV PRIME is a partnership started in 2011 among UC Merced, UC Davis School of Medicine, UCSF School of Medicine and UCSF Fresno. UC Davis originally was the degree-granting institution. Degree-granting responsibility was transferred to UCSF and begins with the class that starts this month. UC Merced remains a participating partner.

 

Inspire

 

UCSF Fresno
People Spotlight

 

Lee Hagerty

UCSF Fresno’s success and growth are a direct result of the dedication and inspiration of our faculty, staff, residents, fellows, students, alumni, partners, donors and friends. Each month in Focus, we introduce you to the people who contribute to the greatness of UCSF Fresno through informal interviews. This month, please meet Lee Hagerty.

What is your name? Nickname?

My name is Lee Michael Hagerty. My true nickname for 20 years in the Emergency Department was “Handsome Lee Hagerty.”

How long have you worked for UCSF Fresno?

I have been with UCSF Fresno since May 2015.

What is your current title and role? What does it entail?

I am medical simulation educator, manager and operations technician for the UCSF Fresno Clinical Skills Lab.  I provide procedural education for medical students and residents through simulated clinical training. This includes using high-fidelity mannequins to simulate high-risk scenarios to help students and residents train for real-life situations or using actors to portray standardized patients with particular health conditions to test resident and medical student patient care skills. 

I also conceive and develop low-cost trainers for suturing, bleeding control and other skills. In addition, I support the educational needs for the Parkmedic and Wilderness Medicine programs at UCSF Fresno and UCSF Fresno’s Mobile HeaL clinic. And I support community education by opening up the skills lab to high school, college and community members so they can experience learning the way doctors are trained.

I schedule all lab sessions; repair simulation mannequins and conduct routine maintenance of mannequins and maintain medical equipment and supplies. I also research and purchase the next advanced trainers and mannequins, and help lead development of future clinical skills support and education at UCSF Fresno. 

What is the favorite aspect of your job at UCSF Fresno?

My favorite aspect of my job is prepping for and teaching a class.  It brings great joy for me to see learners grasp the objective of the training and what faculty or I am trying to convey.

What was your first job?

I was a landscaper for my Uncle Bob’s landscaping business in Fallbrook, CA. My first tax-paying job was at McDonald’s in Orange County.

If you could pick up an instant skill, what would it be and why?

Emergency response or public speaking. I worked in emergency medicine as a Paramedic/EMT for 27 years.  If any medical emergency happened near me I would have the confidence and skills to respond from the training and experience that I have learned from so many great teachers in the medical community.

I also love the challenge of engaging a crowd with what I am presenting.  I never felt nervous speaking in front of an audience. I hear people laughing at my jokes, and usually get a compliment afterward that participants got a lot out the presentation.

Have you had your 15 minutes of fame yet? If yes, what was it and when? If no, what would you like to be famous for?

My only 15 minutes of fame is being among the pioneers who helped make the UCSF Fresno Clinical Skills Lab a reality. We started the lab in 2015.  There was no way of knowing whether it was going to be the success it is today.  It’s a huge success and I hope it remains and grows for many years to come.  I’d also really like to get the golden buzzer on “America’s Got Talent” for best comedy bit.

Do you have a favorite cause or charity you wish people knew more about? What is it and why is it near and dear to you?   

St. Jude Children’s Research Hospital is near and dear to me.  Our church sponsors them through the preschool to help children with severe illness cover their medical care.

The zombie apocalypse is coming, which three people at UCSF Fresno would you want on your team and why?  

My team would include Adom Smith, the building engineer, since he’s my best friend; Kelly Noorani, UCSF Fresno facilities manager, as our hunter/gatherer, and SimMan for a diversion.

Where do you find your inspiration?

I find inspiration in my supervisor Jennifer Dodd, chief of technology, for looking into the future of the Skills Lab. I am thankful for Stacy Sawtelle Vohra, MD, for her support and encouragement to be an effective and valuable service for medical education at UCSF Fresno. And I find inspiration in all faculty educators for their continued support and dedication to the Clinical Skills Lab.

What’s the most important thing you’d like people to know about you? Or what else would you like to add about you, your background or family?

First and foremost, I am a dad. I love my kids and love the awesome memories they bring to me daily.  Also, I’d like people to know that the Clinical Skills Lab services leave behind an amazing experience where you want to keep coming back, and invite your friends and colleagues for an incredible resource and atmosphere again and again. 

 

Supporting UCSF Fresno

Scholarships Needed to Help Recruit and Retain Future Physicians for
the Valley

Photc Courtesy of Reyoot Berry     

By Brandy Ramos Nikaido

UCSF Fresno has made significant progress in addressing the need for physicians in the San Joaquin Valley. Yet, as the region’s diverse population continues to grow and age and existing physicians retire, the Valley’s physician shortage will only worsen. More than 30 percent of practicing physicians in the Valley are over the age of 60 and are expected to retire in the near future. 

Now is the time to bolster doctor training. It takes at least 11 years after high school to produce a practicing physician and can be even longer depending on the specialty.

To adequately address the increasing need for physicians in the Valley, the following are imperative: 

  • A pipeline of Valley students interested in and academically eligible to pursue careers in health care
  • A pathway for Valley students to earn a baccalaureate degree, go to medical school and complete residency and fellowship training close to home 
  • Stable, ongoing funding for residency training and increased number of residency positions in the Valley such as at UCSF Fresno

Growth in medical student enrollment must be tied to growth in residency training. Otherwise, local medical school graduates will go elsewhere for residency – the hands-on, clinical training required to practice independently in the U.S.  In addition, incentives like loan forgiveness will help keep physicians in the region.

According to the American Association of Medical Colleges, medical students in the U.S. graduate with an average $200,000 in education-related debt. UCSF Fresno needs scholarship funds to recruit medical students to UCSF SJV PRIME.

Contributions toward scholarships for SJV PRIME medical students and financial support for UCSF Fresno pipeline programs are two of the ways to ensure a steady stream of physicians for the Valley, especially physicians who have ties to the Valley and want to stay here to practice. 

The two best predictors of where physicians will practice are the area where they grew up and where they complete their training. Join UCSF Fresno in improving health in the San Joaquin Valley by supporting education and partnerships that train future health professionals in the region, for the region. 

To learn more about supporting UCSF Fresno scholarships, please contact Cynthia Harris, director of development at (559) 499-6425 or charris@fresno.ucsf.edu